community paramedic national organization of state offices of rural health regional meeting lansing...
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Community ParamedicNational Organization of State Offices of
Rural Health Regional MeetingLansing August 13, 2015
Marvin Helmker, ManagerEMS Section
Michigan Department of Health and Human [email protected]
517 241-3024
Community Paramedic
Why do people go to the hospital ED?
it’s free!hungrylonelyhurt toe three days agoran out of medication and need a refillrecording at Dr. office told them toED physician is their primary care physicianlegitimate illness/injury which is true emergency
Community Paramedic
Goals: Reduce frequent flyers/super utilizers
cost reduction; better resource utilization
Provide health and risk assessments for vulnerable patients outside of the hospital setting
Connect right patient with right resources
Very good video: www.youtube.comNAEMT transforming EMS
Community Paramedic
Paramedics do: 1000-1500 hours of trainingmedical and trauma assessments12-lead EKGswound carevital signs (BP, P, R, skin, pupils, LS, LOC)med administration (IV, SQ, IM, SL, PO)oxygen administration measure oxygen saturationblood glucose checksadvanced airways (King, LMA, Combitube, ET intubation)work under authority of a medical control physician
Community Paramedic
Paramedics do not: prescribe medicationssutureconclusively diagnoseprovide hospice careread x-raysperform surgeryprovide social work serviceslike being called “ambulance drivers”
Community Paramedic
MDHHS EMS Section ideas: move forward with community paramedicine concept
special study process
gather data
develop education component
rural/urban component
private/not-for-profit/fire-based EMS agencies
explore/develop best practices
Community Paramedic
Challenges:
fee for services (currently EMS only reimbursed for transports)
buy-in from agencies
support from MCAs
Community Paramedic
Rural challenges: will CP work in a rural area?
rural/remote location
limited access to healthcare options
underserved areas for healthcare providers
distance/travel time to access healthcare services
volunteer/paid-on-call EMS agencies
fewer paramedics in rural areas?
Community Paramedic
Sampling of 12 agencies approved to conduct CP special study:
Life EMS Grand RapidsHuron Valley Ambulance Ann ArborCommunity EMS SouthfieldAmerican Medical Response Grand RapidsClinton Area Ambulance St. JohnsPortland Area Ambulance PortlandMedstar Ambulance Clinton Twp.
Community Paramedic
Success stories…
75 y.o. female pt.; diabetes hx.; lying in bed unresponsive; EMS arrives, determines low blood sugar; I.V. dextrose administered with rapid return to normal status; no further complaints; left in care of CP and family; follow-up phone call next day; pt. is fine.
Community Paramedic
Success stories…
94 y.o. female pt.; DIB; swollen legs with pitting edema; wheezes present in lungs; breathing treatment administered; DIB improvement noted; second breathing treatment administered with increased improvement; pt. wishes to remain at home; CP contacted pt’s primary care physician; follow-up appt. made; transportation assistance provided to pt’s appt.
Community Paramedic
Success stories…
68 y.o. male pt.; fell while standing to use walker; small abrasions to L leg; no other injuries found; assisted pt. to recliner; corrected several trip hazards throughout home; determined no need for transport to hosp.; social worker followed up with pt. the next day; pt. doing well.
Community ParamedicSunset over Lake Lansing